曲妥珠单抗联合长春瑞滨对Her-2/neu高表达的转移性乳腺癌的治疗作用

Efficacy and toxicity of trastuzumab combined vinorelbine in 21 patients with HER2 overexpressing metastatic breast cancer

目的观察曲妥珠单抗联合长春瑞滨治疗Her-2/neu高表达的转移性乳腺癌的疗效与毒副作用。方法21例Her-2/neu高表达转移性乳腺癌患者,接受曲妥珠单抗联合长春瑞滨方案治疗,曲妥珠单抗2 mg/kg静脉滴注d1,d8,d15或者6 mg/kg静脉滴注d1,(首次加2 mg/kg),长春瑞滨25 mg/m2静脉推注d1、d8,每21 d重复一次。结果全组21例共完成56个周期(中位数2周期,范围1～6周期),均可评价疗效。完全缓解1例,部分缓解6例,病情稳定4例,病情进展10例,客观有效率(完全缓解加部分缓解)33.33%,中位疾病进展时间3.5个月,1年生存率33%。主要不良反应是骨髓抑制及周围神经炎,部分患者有发热和轻度的心肌劳损。结论曲妥珠单抗联合长春瑞滨方案治疗Her-2/neu高表达的重度复治的转移性乳腺癌患者,仍有一定疗效,且毒副作用轻。

Objective To evaluate the efficacy and toxicity in patients with HER2 overexpressing metastatic breast cancer. Methods Twenty-one patients with HER2 overexpressing metastatic breast cancer entered into the study. Trastutzumab （8 mg/kg day 1, then 6 mg/kg every 21 days or 4 mg/kg, then 2 mg/kg every week） and vinorelbine （25 mg/m^2） was given on days 1 and 8 every 21 days. Results Overall 56 cycles were given to the 21 patients enrolled into the study （mean 2, range 1-6）. All can be evaluated. The response rate was 33.33% （7/21）, one patient achieved complete response （CR）, six patients achieved partial response （PR）, four patients achieved stable disease （SD）, ten patients achieved progressive disease （PD）]. The median time to progression was 3.5 months. One year overall survival was 33%. The major toxicity was myelosuppression and peripheral neuritis. A few patients were observed with fever and lower grade cardiac failure. Conclusion The combination of trastuzumab and vinorelbine is an effective and well tolerated therapy in patients with pretreated metastatic breast cancer.